Evaluation of 4D flow MRI-based non-invasive pressure assessment in aortic coarctations
| Autor: | Federica Cuomo, Francesca Romana Pluchinotta, Massimo Lombardi, Carlos Alberto Figueroa, Filippo Piatti, Federico Lucherini, Selene Pirola, Alberto Redaelli, Mario Carminati, Xiao Yun Xu, Simone Saitta, Christian Geppert, Emiliano Votta |
|---|---|
| Přispěvatelé: | Commission of the European Communities |
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Patient-Specific Modeling
Technology Cardiac Catheterization 4D flow MRI Aortic coarctation Fluid dynamics Non-invasive pressure difference estimation Pressure Poisson equation 1106 Human Movement and Sports Sciences Hemodynamics 02 engineering and technology GUIDELINES Poisson distribution Engineering 0302 clinical medicine 0903 Biomedical Engineering VESSELS Orthopedics and Sports Medicine Aorta Mathematics medicine.diagnostic_test Rehabilitation Models Cardiovascular STIFFNESS Mechanics Magnetic Resonance Imaging CONGENITAL HEART-DISEASE symbols Life Sciences & Biomedicine Algorithms Blood Flow Velocity 0913 Mechanical Engineering Finite Element Analysis 0206 medical engineering Biomedical Engineering Biophysics 03 medical and health sciences symbols.namesake MANAGEMENT Pressure medicine Humans Boundary value problem Systole Engineering Biomedical Science & Technology BLOOD-FLOW Reproducibility of Results Magnetic resonance imaging Blood flow QUANTIFICATION 020601 biomedical engineering Noise PULSE-WAVE VELOCITY Feasibility Studies 030217 neurology & neurosurgery |
| Popis: | Severity of aortic coarctation (CoA) is currently assessed by estimating trans-coarctation pressure drops through cardiac catheterization or echocardiography. In principle, more detailed information could be obtained non-invasively based on space- and time-resolved magnetic resonance imaging (4D flow) data. Yet the limitations of this imaging technique require testing the accuracy of 4D flow-derived hemodynamic quantities against other methodologies. With the objective of assessing the feasibility and accuracy of this non-invasive method to support the clinical diagnosis of CoA, we developed an algorithm (4DF-FEPPE) to obtain relative pressure distributions from 4D flow data by solving the Poisson pressure equation. 4DF-FEPPE was tested against results from a patient-specific fluid-structure interaction (FSI) simulation, whose patient-specific boundary conditions were prescribed based on 4D flow data. Since numerical simulations provide noise-free pressure fields on fine spatial and temporal scales, our analysis allowed to assess the uncertainties related to 4D flow noise and limited resolution. 4DF-FEPPE and FSI results were compared on a series of cross-sections along the aorta. Bland-Altman analysis revealed very good agreement between the two methodologies in terms of instantaneous data at peak systole, end-diastole and time-averaged values: biases (means of differences) were +0.4 mmHg, −1.1 mmHg and +0.6 mmHg, respectively. Limits of agreement (2 SD) were ±0.978 mmHg, ±1.06 mmHg and ±1.97 mmHg, respectively. Peak-to-peak and maximum trans-coarctation pressure drops obtained with 4DF-FEPPE differed from FSI results by 0.75 mmHg and −1.34 mmHg respectively. The present study considers important validation aspects of non-invasive pressure difference estimation based on 4D flow MRI, showing the potential of this technology to be more broadly applied to the clinical practice. |
| Databáze: | OpenAIRE |
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